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[Prevalence of antiphospholipid antibodies in Horton's disease and in polymyalgia rheumatica]
C Hulin1, E Hachulla, U Michon-Pasturel
1Service de médecine interne, hôpital Clauae-Huriez, CHRU, Lille.
Insights
Antiphospholipid antibodies (APL) are common in giant cell arteritis and polymyalgia rheumatica but do not correlate with ischemic events. These antibodies disappear quickly after corticosteroid treatment begins.
Area of Science:
- Rheumatology
- Immunology
- Vascular Medicine
Context:
- Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are common inflammatory conditions in the elderly.
- Antiphospholipid antibodies (APL), specifically anticardiolipin antibodies (ACL), are frequently detected in patients with GCA and PMR.
- The clinical significance of APL in GCA and PMR, particularly concerning ischemic events, remains a subject of debate.
Purpose:
- To investigate the prevalence of APL in patients diagnosed with GCA and/or PMR.
- To determine the association between APL and the occurrence of ischemic events in these patient cohorts.
- To observe the impact of corticosteroid treatment on APL levels.
Summary:
- A retrospective study analyzed 62 patients with GCA and/or PMR.
- High IgG ACL levels were found in 41% of GCA patients and 64% of PMR patients before treatment, significantly higher than controls.
- No correlation was found between ACL presence and ischemic events, despite higher ACL prevalence in GCA patients.
- ACL levels decreased rapidly following the initiation of corticosteroid therapy.
Impact:
- This study clarifies that ACL, while prevalent in GCA and PMR, are not indicative of ischemic risk in these conditions.
- The findings suggest that APL detection in GCA/PMR patients may not require specific interventions for ischemic event prevention.
- The rapid resolution of ACL with corticosteroids highlights a potential marker of treatment response or disease activity modulation.
Purpose:
Antiphospholipid antibodies (APL) are frequently observed in the course of giant cell arteritis and polymyalgia rheumatica. However, their role and relationships with potential ischemic events are still debated.
Methods:
To determine the prevalence of APL in relation with ischemic events, 62 patients with giant cell arteritis and/or polymyalgia rheumatica were retrospectively studied.
Results:
Before corticosteroid treatment 41% of the 51 patients with giant cell arteritis and 64% of the 11 patients with isolated polymyalgic rheumatica had high IgG ACL levels, with a frequency significantly higher than that (15.6%) of the control group which was composed of healthy elderly. IgM ACL were found in only two patients with giant cell arteritis. There was no correlation between the occurrence of an ischemic event (22 ischemic events in the 51 patients with giant cell arteritis) and the presence of ACL, even though the latter were more frequently observed in the giant cell arteritis group (52% versus 41% in non ischemic patients). The prevalence of ACL increased, reaching 59% if lupus anticoagulant was associated, but the difference was not significant. ACL disappeared soon after corticosteroid therapy had been initiated.
Conclusion:
Though ACL are frequently seen in giant cell arteritis and/or polymyalgia rheumatica, they are not related to ischemic events and disappear rapidly after corticosteroid treatment.